Legal Question in Insurance Law in New York

Re: Employer had 2nd set of ''books''

There is a law that makes it a crime knowingly to make a materially false statement to an insurance company in connection with the issuance of an insurance policy or a claim thereunder. The statute is Title 176 of the Penal Law, entitled "Insurance Fraud." The statute defines "Fraudulent Insurance Act" as preparing, causing the preparation of, of presenting to an insurance company any materially false statement in connection with insurance policies.

I am not saying that anyone broke the law. I am just saying that there is a statute, Article 176 of the Penal Law, that makes it a crime to commit insurance fraud.

The logical place to report a fraud such as you describe would be the insurance carrier. If you do not know who the carrier is, then you do not have real evidence of a crime having been committed, and you should get on with your life. The doctor may simply have a personality disorder that causes him to tell tales. If you have handled insurance paperwork relating to the doctor's coverage, then you should be able to identify which carrier writes his professional liabiity, commercial general liability, and/or excess/umbrella liabiity coverage. Since all of the carriers cooperate, if you report the doctor to one, it's as effective as if you contacted all of them.

HOWEVER, BE VERY CAREFUL OR YOU COULD POTENTIALLY FACE A CRIMINAL INVESTIGATION OR CHARGES. If you prepared or otherwide handled paperwork in connection with the doctor's insurance applications, you could have potential criminal exposure. You should engage counsel before you disclose anything to anyone.

One gathers that beyond his insurance fraud, this doctor is not on anyone's short list of fsvorite people. Do not let your distaste for this piece of work get in the way of your self-protection. Will your life really be significantly less enjoyable if you do not turn him in? Is the satisfaction you will derive worth the risk? Approach the situation dispassionately and soberly, and make your decision based on factors other than emotion.